Breast Cancer Reconstruction via Tissue Expanders

The Park Clinic for Plastic Surgery performs more breast cancer reconstruction than anyone on the Alabama Gulf Coast. Many of the cases involve the use of a tissue expander. You may have heard the term before, but what is its role in breast cancer reconstruction?
After your mastectomy (surgery to remove your breast), you’ll have a breast reconstruction surgery using a tissue expander. A tissue expander is an empty breast implant that your surgeon will fill with normal saline over about 6 to 8 weeks until it reaches the breast size that you and your surgeon decided on.
There are 2 ways to do this type of reconstruction:
Sub-muscular placement: This is when your surgeon makes a pocket under your large pectoralis muscle in your chest and places a tissue expander in that space.
Your skin is very weak and fragile after your mastectomy, but your muscle is a barrier between your skin and tissue expander. If your tissue expander is placed under the muscle, it will be filled with normal saline.
Pre-pectoral placement: This is when your surgeon places the expander over your large pectoralis muscle.
After a mastectomy, your skin is very weak and fragile. It’s important to help take pressure off the skin when your skin is first healing after your mastectomy. If your tissue expander is placed over the muscle, it will be filled with air which is less dense than normal saline.
If the tissue expander is placed over your muscle, your surgeon will also place a mesh around the expander. This is called acellular dermal matrix. The mesh will help support the expander while your skin is healing. About 2 weeks after your surgery, the air that the tissue expander is filled with will be changed to normal saline.
Your surgeon will discuss the placement of the expander with you at your pre-surgical consultation. The usual hospital stay for breast reconstruction is less than 24 hours (1 day).
About 4 to 8 weeks after the tissue expansion is finished, you’ll have a second surgery using the same incisions (surgical cuts) to remove the tissue expander and insert the permanent breast implant that you choose with your plastic surgeon.
You’ll go home the same day of surgery. If you’re getting chemotherapy or radiation therapy, you’ll need to wait until after your treatment to place the permanent implant.